Ronald Scott Debruin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16-30001126 Issued in VT

Practice address

84 Water Tower Rd
Unit #2
Enosburg Falls, VT 05450-6097

Phone

(802) 933-8316

Fax

(802) 933-6555

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Enosburg Family Dental

  • General Practice Dentistry
  • Enosburg Falls, VT
  • NPI 1619896834
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194803387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 WATER TOWER RD",
            "address_2": "UNIT #2",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "054506097",
            "telephone_number": "802-933-8316",
            "fax_number": "802-933-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 WATER TOWER RD",
            "address_2": "UNIT #2",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "054506097",
            "telephone_number": "802-933-8316",
            "fax_number": "802-933-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRUIN",
        "first_name": "RONALD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "16-30001126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003075",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Chan, PHARMD
• Cold Hollow Family Practice
• Cold Hollow Family Practice, PC
• Samantha O'Sullivan Cooney
• Counseling and Wellness
• Enosburg Family Dental
• Pierre Emile Etienne, MD
• Franklin Northeast Supervisory Union
• Andrew Gagne, PHARMD
• Richard William Gallagher, AGNP

• General Practice Dentistry in Enosburg Falls, VT
• Providers in Enosburg Falls, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.